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4 governance obstacles Mr. Modi needs to cross to seal the 2019 hurdle race

With the highest number of MLAs of any party in 24 years and UP firmly in the bag, the NDA under Prime Minister Narendra Modi is well on its way to match the political might of the old Congress under Nehru and Indira. With the dark days of political instability behind us and a decisive leader, India has a chance to finally take the big leap forward on the economic front and claim its rightful place on the world map.

But to get there, Modi administration will have to deftly tackle these 4 big challenges we face:

  1. Universal healthcare
  2. Universal primary education
  3. Universal social security & shelter
  4. Personal freedom, liberty, law & justice

In this article, based on my own experience I propose how the Modi administration could go about tackling these issues.

Universal healthcare

Often, when I travel in the so-called advanced economy countries and find people living in remote areas seemingly away from civilization, my first thought is – what do they do when there is a medical emergency? I find that they can get access to the nearest hospital (which may be many miles away) – by one simple phone call. A chopper would be there in minutes and shift the patient in real time for medical help.

I was involved in a major car crash in USA and saw the emergency response first hand. I was trapped inside my car for a short while and by the time I crawled out on my own (without any injury) I found that the police and ambulance had arrived and the fire engine was on its way. They were there in maybe under 10 minutes. I was driven to the nearest hospital and medical tests were done on priority. I also saw at the front entrance, a chopper land ferrying a pregnant woman in an advanced state of labour.

On the other hand, in India you read of accident victims lying on the road bleeding to death, ambulances stuck in traffic, emergency patients denied access to a road or a hospital because a VVIP visit and you begin to get a sense of how badly we have failed.

It will take time to change the system and culture, but two main areas (amongst many) which can be fixed without too much effort are Insurance and Primary Healthcare.

Insurance:

We need to have very rigorous health insurance system where even the poorest of poor get access to quality healthcare. These schemes must cover the plethora of private hospitals and these hospitals must come under a common law wherein they cannot turn away patients and the fundamental target must be to save lives, provide emergency care and treatment.

Citizens can take their own insurance covers also for added benefit. Cashless treatment in hospitals must be the norm and covered under either the universal or individual insurance schemes. Today this is missing and while the current government has started a health insurance scheme for the poor and marginalized (Pradhan Mantri Suraksha Bima Yojana), it is still linked to a bank account.

Also, it is my considered opinion that it has not been given sufficient publicity, focus or attention. This could be due to lack of rigorous systems in place or the propensity of the administration to consider this an avoidable effort. But this needs to be pursued aggressively by the govt, implemented and demonstrated to the citizens that it works. The dividends of such an effort would be humungous.

Primary healthcare:

In some states, doctors by law are supposed to serve in rural areas, but very few do so. We don’t need laws making rural service compulsory, instead, it is critical to understand that doctors posted in remote, rural areas find themselves losing the opportunity to expand their knowledge, have no access to education, housing, infrastructure or medicines in such locations and unless an individual is being idealistic, 99% of the people will find a way to avoid this posting.

The government can learn from the milk dairy industry, which since 4 decades is providing quality healthcare to cows/buffaloes in even the remotest of villages and the veterinary doctors enjoy the postings. So how did they do it?

Even in the eighties, all the doctors were posted at the nearest district headquarters. Each had a car equipped with a radio and their movement monitored by a central control room. Each doctor/car would traverse a prefixed route every day covering a set of villages on a weekly basis and they dispensed medical care and medicines to the cows. The village knew on what day the doctor would come and would be ready. If, however, there was an emergency, a separate car/doctor would drive down to that village on the other days and a special charge would be levied to discourage people from misusing the facility. If the emergency was dire, the control room would know which car/doctor was driving anywhere nearest to that village and ask them to take a detour.

This system ensured that the doctors stayed in urban habitation, had access to education, housing/infra for their families and returned home each night. Many grateful villagers would often bestow upon the doctor freebies like some fresh vegetables, fruits or such as a mark of gratitude, friendship, affection. Today with sophisticated communication technology and automobiles there is no reason why such a system cannot be implemented across the country. This is a necessity and can be a huge vote-puller for any party/Govt which implements this.

Universal primary education

In the case of Universal education, the Government passed an RTE law and dusted its hands off on a job well done. Problem solved. But has it? Primary education is left to the private sector and most of the government(municipal) schools have fared poorly. The private schools charge obscene fees, have many bored wives of corporate honchos and officers as teachers to protect themselves against government action & once again it is a business not treated as an essential service in nation building.

Given the geographies and challenges of our infra and safety of children, the government must open smaller primary schools in each locality which are accessible even by walk if required in an emergency, hire the women in that locality and train them. Admission and transfers must be made easy so that even the children of construction workers and such who live in that area can study.

The government can invite corporates to sponsor and manage these education initiatives under CSR funds and if needed give tax breaks. There is a 1.1% education cess on imports alone and in 2015-2016 total imports were $379,596 M, this translates to about $4176 M or INR 28,811 Crores. The budget states a figure of INR 29,407 Crores. Given that the under-14 population of India is 35 Crores, it is entirely possible to provide this access.

What gets measured, gets improved and so to improve the quality of these Gov run schools, the schools must be made more transparent and their performance should be measured and be open for public scrutiny. Financial and social Incentives of the staff should be linked to the qualitative and quantitative performance of the school.

Universal social security

It will always remain a dream to have 100% employment, and often global incidents or health related issues or physical debilitation create a mass of people who lose the ability to earn a living.

If we believe in human dignity, then there must be a universal fund and infrastructure that can take care of the most in need and support them. Again one may not be able to provide the best but society, corporate must be encouraged to create systems that can provide the basic minimum every citizen deserves. There can be night shelters for the homeless (especially during winter), community soup kitchens to feed the destitute. And insurance schemes which the employed can subscribe to whereby if they lose their job or a limb, they can still earn a living wage.

Personal freedom, liberty, law & justice

One cannot grow and expand his horizons unless she has freedom. Often, many say that we have too much democracy. Maybe true in a way, but what we probably have is selective freedom and discretionary democracy. This must change. Laws must be changed to protect every thought, every idea to flourish and the 18th-century notions of sedition and blasphemy must go. This freedom of expression or speech must be absolute and not limited to who is powerful and has muscle power and thus they think they are right.  If a left wing opinion must be respected, then equal respect must be given to a right wing view. The law cannot differentiate between the two.

The law must be framed such that this freedom is protected and there are clear limitations by way of discipline and conduct to protect the sovereignty and security of the country. When these are transgressed, the law must take its own course in a swift and firm manner.

Even after 70 years of independence, justice system remains in the grips of the rich and powerful. Every citizen must have the confidence that they can seek protection by the justice system. Today, often policemen refuse to even file FIRs, or act in a partisan manner, get influenced by political and money power. Cases that go to court get dragged for decades. Justice must not only be timely but also seen to be delivered. Punishment must be equally swift. The pathetic state of our police systems and judiciary can be gauged by the fact that rarely does a citizen wants to seek the help of the law.

Here again, the government understands the challenge but the system (including the police, judges and judicial system) itself opposes changes, since they have become units dispensing favours and wielding power. Unless there are radical changes in police and judiciary – India, however democratic, can never occupy the high seat of being truly called an advanced nation.

***

Social Media, 2014 election and the current government has brought in a huge change when it comes to citizen involvement in issues. Quite often, this manifests itself as angst and impatience; it’s imperative to channelize this engagement into positive nation building activity and not become private battles over trivial issues. India today is at the cross roads of change and the road we take will determine our future.

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Ravindra Vasisht
a senior executive based out of Bangalor with interests in Politics and Public policy.

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